Abstract
ObjectiveThe pathophysiological mechanism of TD remains unknown. All previous studies, using the region-of-interest method, focused on basal ganglion areas, were with inconsistent results. This whole-brain voxel-based morphometry (VBM) study investigate the grey matter abnormality of TD and its correlates with clinical ratings.MethodHigh resolution T1-weighted brain volumetric MRI from 25 schizophrenia patients with TD (TD group), 25 age-, gender-, and handedness-matched schizophrenia patients without TD (non-TD group), and 25 matched healthy subjects (NC group) were analyzed using a VBM approach. Clinical ratings included the Positive and Negative Symptom Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), and the Simpson-Angus Scale (SAS).ResultsThe TD group had significantly smaller total gray matter volumes than the NC group (p = 0.05). Compared to the non-TD group, the TD group had significantly higher PANSS negative (p<0.001), SAS (p<0.001), and AIMS (p<0.001) scores; and smaller bilateral inferior frontal gyrus, which correlated negatively with the PANSS negative scores (r = −0.366, p<0.05); and smaller right superior frontal gyrus, which correlated negatively with AIMS scores (r = −0.399, p<0.001), and PANSS general score (r = −0.338, p<0.05).LimitationsThe cross-section design can’t separate the gray matter change to TD from the context of the illness of schizophrenia, although TD with more severe clinical psychopathology could be a phenotype.ConclusionsThe schizophrenia patients with TD had significantly reduced gray matter, mostly at the bilateral inferior frontal gyrus and the right superior frontal gyrus, which correlated with severity of clinical symptoms and involuntary movement, respectively.
Highlights
Tardive dyskinesia (TD), a severe and disabling side effect of antipsychotics, is characterized by late-onset, repetitive, involuntary choreiform movements, tics and grimaces of the orofacial muscles, and dyskinesia of the distal limbs, paraspinal muscles, and diaphragm [1]; which may cause appearance deformity, daily function disability, and even legal sues [2,3]
The schizophrenia patients with TD had significantly reduced gray matter, mostly at the bilateral inferior frontal gyrus and the right superior frontal gyrus, which correlated with severity of clinical symptoms and involuntary movement, respectively
There was no significant difference in the age at onset of illness, duration of illness, or antipsychotic chlorpromazine equivalent dose between the two groups of schizophrenia subjects; who all received only one antipsychotic drug
Summary
Tardive dyskinesia (TD), a severe and disabling side effect of antipsychotics, is characterized by late-onset, repetitive, involuntary choreiform movements, tics and grimaces of the orofacial muscles, and dyskinesia of the distal limbs, paraspinal muscles, and diaphragm [1]; which may cause appearance deformity, daily function disability, and even legal sues [2,3]. More than half of TD cases may persist, even after conventional antipyschotics are switched to atypical antipsychotics [4] or antipsychotics are discontinued [5]. There has been less attention focused on TD for the past few years since the development of atypical antipsychotics, which is regarded to have lowered the risk of TD. The annualized incidence of TD with atypical antipsychotics was still up to 3.9% [6,7]; this was lower than that of conventional antipsychotics (5.5%), it was higher than expected. Woods SW et al found adjusted tardive dyskinesia incidence rate-ratio for subjects treated with atypical antipsychotics alone was 0.68 (95% CI, 0.29–1.64) compared to conventional antipsychotics by following 352 patients for 4 years [8]. Gaining an understanding of the pathophysiology of TD is still important [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
